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Straight, No Chaser In the News: Abstinence-Only Education and Sexual Health

By Jeffrey Sterling, MD July 19, 2019


In my capacity as a physician, when it comes to patients, I often say it’s not my job to judge but to treat. However, as a public health consideration it would be nothing short of unethical not to speak on certain matters that affect communities and entire nations.
For a long time, matters of health weren’t subject to the whims of politicians. As examples, matters of women’s health, immunizations and issues pitting corporate interests against the public’s health were generally settled in favor of science and health prevention and promotion. The United States not only valued education and science but led the way for the rest of the world to follow. The U.S. generally ascribed to the notion that “knowledge is power.” Unfortunately, whether due to religious, “freedom” or political considerations, recent trends have substantially altered this stance. The reasons why a change has occurred isn’t as important of a public health consideration as much as the fact that a change has occurred.
For example, you may or may not be aware of the presence of abstinence-only schools. Perhaps it would be one thing to promote an agenda-based education (or lack thereof) on the strict basis of religious preference, but in those examples in which people are actually attempting to argue opinions as if they’re facts is a bridge too far to cross (e.g. claims that abstinence-only educations are more effective than comprehensive sexual education). The problem with simply acquiescing those with the loudest screams in these matters is that neither science nor health is a matter of opinion. These decisions have consequences, and failure to follow the science has predictable consequences.


So here we are with news this week from a rural town in Texas that features an abstinence-only school. The U.S. Centers for Disease Control and Prevention has announced an outbreak of chlamydia – 20 of the 300 students have tested positive for chlamydia (review this Straight, No Chaser post on Chlamydia for details on this sexually transmitted infection). In fact, the CDC is calling the outbreak “a health issue at epidemic proportions.”


It’s an admirable goal to promote abstinence. It’s also admirable to promote sexual responsibility. It’s not admirable to deny education or to be oblivious to the fact that the average age of initial sexual activity is 12 years old. A posture of “if kids are not having any sexual activity, they can’t get this disease…that’s not a bad program” is unbecoming of an educator or school superintendent, particularly for a disease that leaves up to 20% of untreated women sterile if they develop pelvic inflammatory disease (PID) as a result of contracting chlamydia. Sexual health prevention and promotion are not the same as promoting illegal or immoral behavior. Considerations of promoting abstinence and sexual education are not mutually exclusive.


It is past time to acknowledge that the consequences of denying education in the pursuit of abstinence are as consequential as promoting promiscuity. For the record, it is a matter of fact, not opinion, that those educated in abstinence-only schools have higher rates of sexual activity, teen pregnancy and sexually transmitted infections.

Shouldn’t facts matter?

I’ll leave you with this thought: is it a greater sin for a teenager to be human or for adults to knowingly expose children to conditions that could leave them scarred for a lifetime?
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